TY - JOUR
T1 - Race is associated with differences in airway inflammation in patients with asthma
AU - Nyenhuis, Sharmilee M.
AU - Krishnan, Jerry A.
AU - Berry, Alalia
AU - Calhoun, William J.
AU - Chinchilli, Vernon M.
AU - Engle, Linda
AU - Grossman, Nicole
AU - Holguin, Fernando
AU - Israel, Elliot
AU - Kittles, Rick A.
AU - Kraft, Monica
AU - Lazarus, Stephen C.
AU - Lehman, Erik B.
AU - Mauger, David T.
AU - Moy, James N.
AU - Peters, Stephen P.
AU - Phipatanakul, Wanda
AU - Smith, Lewis J.
AU - Sumino, Kaharu
AU - Szefler, Stanley J.
AU - Wechsler, Michael E.
AU - Wenzel, Sally
AU - White, Steven R.
AU - Ackerman, Steven J.
N1 - Funding Information:
Supported by grant U10HL098096 from the National Institutes of Health/National Heart, Lung, and Blood Institute Chicago Metropolitan AsthmaNet Consortium (CMAC) and U10 HL074225, U10 HLA074227, U10 HLA074231, U10 HLA074204, U10 HLA074212, U10 HLA074073, U10 HLA074206, U10 HLA074208, U10 HLA074218, and R21 HL118588-01 (to S.J.A.). Also supported by the American Academy of Allergy, Asthma, & Immunology/Association of Specialty Professors T. Franklin Williams Scholar (to S.M.N.), the University of Illinois at Chicago (UIC) Center for Clinical and Translational Science (CCTS), award nos. KL2RR029878 (to S.M.N.) and UL1TR000050 (to J.A.K.) from the National Center for Advancing Translational Sciences. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Publisher Copyright:
© 2016
PY - 2017/7
Y1 - 2017/7
N2 - Background African American subjects have a greater burden from asthma compared with white subjects. Whether the pattern of airway inflammation differs between African American and white subjects is unclear. Objective We sought to compare sputum airway inflammatory phenotypes of African American and white subjects treated or not with inhaled corticosteroids (ICSs; ICS+ and ICS−, respectively). Methods We performed a secondary analysis of self-identified African American and white subjects with asthma enrolled in clinical trials conducted by the National Heart, Lung, and Blood Institute–sponsored Asthma Clinical Research Network and AsthmaNet. Demographics, clinical characteristics, and sputum cytology after sputum induction were examined. We used a sputum eosinophil 2% cut point to define subjects with either an eosinophilic (≥2%) or noneosinophilic (<2%) inflammatory phenotype. Results Among 1018 participants, African American subjects (n = 264) had a lower FEV1 percent predicted (80% vs 85%, P <.01), greater total IgE levels (197 vs 120 IU/mL, P <.01), and a greater proportion with uncontrolled asthma (43% vs 28%, P <.01) compared with white subjects (n = 754). There were 922 subjects in the ICS+ group (248 African American and 674 white subjects) and 298 subjects in the ICS− group (49 African American and 249 white subjects). Eosinophilic airway inflammation was not significantly different between African American and white subjects in either group (percentage with eosinophilic phenotype: ICS+ group: 19% vs 16%, P =.28; ICS− group: 39% vs 35%, P =.65; respectively). However, when adjusted for confounding factors, African American subjects were more likely to exhibit eosinophilic airway inflammation than white subjects in the ICS+ group (odds ratio, 1.58; 95% CI, 1.01-2.48; P =.046) but not in the ICS− group (P =.984). Conclusion African American subjects exhibit greater eosinophilic airway inflammation, which might explain the greater asthma burden in this population.
AB - Background African American subjects have a greater burden from asthma compared with white subjects. Whether the pattern of airway inflammation differs between African American and white subjects is unclear. Objective We sought to compare sputum airway inflammatory phenotypes of African American and white subjects treated or not with inhaled corticosteroids (ICSs; ICS+ and ICS−, respectively). Methods We performed a secondary analysis of self-identified African American and white subjects with asthma enrolled in clinical trials conducted by the National Heart, Lung, and Blood Institute–sponsored Asthma Clinical Research Network and AsthmaNet. Demographics, clinical characteristics, and sputum cytology after sputum induction were examined. We used a sputum eosinophil 2% cut point to define subjects with either an eosinophilic (≥2%) or noneosinophilic (<2%) inflammatory phenotype. Results Among 1018 participants, African American subjects (n = 264) had a lower FEV1 percent predicted (80% vs 85%, P <.01), greater total IgE levels (197 vs 120 IU/mL, P <.01), and a greater proportion with uncontrolled asthma (43% vs 28%, P <.01) compared with white subjects (n = 754). There were 922 subjects in the ICS+ group (248 African American and 674 white subjects) and 298 subjects in the ICS− group (49 African American and 249 white subjects). Eosinophilic airway inflammation was not significantly different between African American and white subjects in either group (percentage with eosinophilic phenotype: ICS+ group: 19% vs 16%, P =.28; ICS− group: 39% vs 35%, P =.65; respectively). However, when adjusted for confounding factors, African American subjects were more likely to exhibit eosinophilic airway inflammation than white subjects in the ICS+ group (odds ratio, 1.58; 95% CI, 1.01-2.48; P =.046) but not in the ICS− group (P =.984). Conclusion African American subjects exhibit greater eosinophilic airway inflammation, which might explain the greater asthma burden in this population.
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U2 - 10.1016/j.jaci.2016.10.024
DO - 10.1016/j.jaci.2016.10.024
M3 - Article
C2 - 28069248
AN - SCOPUS:85008618902
SN - 0091-6749
VL - 140
SP - 257-265.e11
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
IS - 1
ER -